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Acute cholecystitis (AC) is a severe complication after cardiovascular surgery (CS). The purpose of this study was to delineate the clinical picture of AC after CS to propose an optimal treatment strategy.

We retrospectively reviewed the records of 88 patients who underwent cholecystectomy for grade II or III AC between 2008 and 2019 (AC after CS Group CS, n=37; AC without CS Group non-CS, n=51).

The proportion of grade III AC in Group CS was significantly higher than that in Group non-CS (73% vs 41%, P=.005). Furthermore, the incidences of acalculous (81% vs 39%) and gangrenous (86% vs 59%) AC were significantly higher in Group CS (P<.05 for both). In Group CS, 11 patients had had percutaneous drainage preceding surgery, for whom cholecystectomy within 3days was eventually necessary because their general condition was exacerbated. The incidence of a positive culture from the gallbladder bile and blood samples of Group CS were significantly higher (P<.05 for both); multidrug-resistant bacteria were detected at an especially high rate. However, the morbidity rate was comparable, and zero mortality was achieved in both groups.

Timely surgical intervention without hesitation is recommended for AC after CS.
Timely surgical intervention without hesitation is recommended for AC after CS.
The purpose of this ex vivo study is to investigate whether it is possible to pre-determine and set the optimal separation times for the SWEEPS ErYAG laser pulses pair during laser-assisted irrigation of endodontic root canals based on known lateral dimensions of the endodontic access cavities of different types of teeth.

As the optimal SWEEPS laser pulse pair separation for enhanced shockwave generation depends on the life-cycle of a single-pulse bubble, measurements of the oscillation time T
of the ErYAG laser-generated bubble were made in 23 different endodontic access cavities of different types of teeth progressively widened in three different steps, into larger cavities, for a total of 69 cavities of different shapes and sizes. Different fiber-tip geometries (flat and radial), laser pulse energies (10 mJ and 20 mJ) and depth of fiber-tip insertion (2 mm and 4 mm) were also investigated. The obtained data were then analyzed using the reported relationship between the bubble oscillation time and theAuthors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.
In spite of the endodontic cavities being non-cylindrical and of varied shape and size, the bubble oscillation time TB and the corresponding optimal SWEEPS separation time can be well predicted using a single characteristic dimension of the access cavity. This finding enables a simple and practical method for determining optimal conditions for shock wave generation and enhanced photodynamic streaming in differently shaped and sized root canals, leading to improved treatment efficacy and safety of root canal irrigation. Lasers Surg. Med. 2020. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.
One in five patients experience chronic pain 12months following total knee arthroplasty (TKA). This longitudinal study used a person-centred approach to identify subgroups of patients with distinct chronic pain profiles following TKA and identified preoperative characteristics associated with these profiles.

On the day before surgery, 202 patients completed questionnaires that assessed pain, interference with functioning, fatigue, anxiety, depression and illness perceptions. Average and worst pain were assessed prior to surgery, on postoperative day 4, at 6week and at 3 and 12months following surgery. Using growth mixture modelling, two subgroups with distinct average and worst pain profiles were identified.

Patients in the "lower average" and "lower worst" pain classes had moderate preoperative pain scores that decreased over the remaining 9months following TKA. Patients in the "higher average" and "higher worst" pain classes had relatively higher preoperative pain scores that increased during the firsotal knee arthroplasty that may contribute to our understanding of the transition from acute to chronic pain. Our results may be used to identify patients at higher risk for poorer outcomes based on preoperative risk factors.
We aimed to study the effect of social containment mandates on ACS presentation during COVID-19 pandemic using location activity and mobility data from mobile phone map services.

We conducted a cross-sectional study using data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) including all ACS presentations during the pandemic until 7 May 2020. Using a count regression model, we adjusted for day of the week, daily weather and incidence of COVID-19.

A 10% increase in activity around areas of residence was associated with 38% lower rates of ACS hospitalizations, whereas increased activity relating to retail and recreation, grocery stores and pharmacies, workplaces and mode of mobility was associated with 10-20% higher rates of ACS hospitalizations.

Government policy regarding social containment mandates has important public health implications for medical emergencies such as ACS and may explain the decline in ACS presentations observed during COVID-19 pandemic.
Government policy regarding social containment mandates has important public health implications for medical emergencies such as ACS and may explain the decline in ACS presentations observed during COVID-19 pandemic.The main goal of this study is to investigate the effect of soil properties such as permeability on the dispersion and movement of a water dissolved contaminant in three types of soil in saturated and 2D conditions. The experimental modeling was conducted using a constructed sand box. In order to evaluate the effect of soils particle size on the distribution and self-remediation of the contaminant, three types of soil, as coarse, medium, and fine-grained sand were used. Results of experiments showed that, at the first 25% of the test time, the contaminated area reduction rate in all three specimens varies significantly, so that for the medium and coarse sand, it is 2.2 and 3 times that of fine sand, respectively. The contaminant width reduction at the first 25% of the test time was 5%, 6%, and 35% for the fine, medium, and coarse sand, respectively, while the contaminant length reduction was 13%, 18%, and 37% for the fine, medium, and coarse sand, respectively. In addition, by comparing the contaminant movement in the saturated and semi-saturated areas, it was observed that the longitudinal and transverse movement of the contaminant under the water level are almost 2.5 times of the semi-saturated area. PRACTITIONER POINTS Reduction rate of solution area in fine, medium and coarse-grained sample are nearly convex, linear and concave-shaped, respectively. The remediation process in saturated zones is implemented in both directions with higher intensity in a shorter time than unsaturated zones. In the strip formed plumes, the volume of the self-remediation is proportional to the time intervals during the test. In the elliptic masses the self-purification amount is lower at the beginning, due to the small cross-section ending of the contamination mass.
Papillary thyroid cancer (PTC) usually metastasizes via lymphatic channels in a sequential fashion, first to the central compartment, followed by the lateral neck. PTC patients diagnosed with lateral neck disease (N1b) without proof for central involvement traditionally undergo prophylactic central neck dissection (pCND). However, substantial evidence on outcomes to support this approach is lacking.

We conducted a dual center retrospective study to compare the rate of central neck recurrence between N1b PTC patients undergoing pCND and those spared pCND. All patients diagnosed with N1b PTC who underwent total thyroidectomy and lateral neck dissections with or without pCND between January 1998 and December 2015 were included in this study. The rates of central neck recurrences were compared between the groups.

The 111 patients who met the inclusion criteria were 44 females (39.6%) and 67 males (60.4%), with a mean age of 50.2 ± 17.7 years, and a mean follow-up of 10.2 ± 5.3 years. Sixty patients (54.1%) underwent a pCND and 51 patients (45.9%) did not (non-pCND). selleck chemical During follow-up, 18 patients (16.2%) had level VI recurrences, 13 in the pCND group and 5 in the non-pCND group. Cox-regression models with propensity scoring did not reveal any inclination or an advantage for performing pCND.

The present study demonstrated no advantage in performing pCND to prevent central neck recurrence among PTC patients with lateral neck involvement only. These findings question the need for pCND in patients without clinical evidence of central neck disease.
The present study demonstrated no advantage in performing pCND to prevent central neck recurrence among PTC patients with lateral neck involvement only. These findings question the need for pCND in patients without clinical evidence of central neck disease.
Patterns of cognitive appraisal related to chronic pain may manifest differentially across time due to a variety of factors, but variability of injustice appraisals across time has not been examined. The current study details the validation of a brief, daily version of the Injustice Experience Questionnaire (IEQ), which measures injustice appraisals related to the experience of pain and disability.

Injustice Experience Questionnaire items were adapted for daily use and evaluated using cognitive interviews, and the resulting measure was administered for 10days to two Internet-based samples of US adults with chronic lower back pain.

Study 1 (N=126) refined the 12-item IEQ measure into a six-item short form; exploratory factor analyses suggested optimal model fit for the two-factor model established in the original IEQ. Using confirmatory factor analyses, Study 2 (N=131) replicated the two-factor structure and demonstrated significant correlations of the Daily IEQ with other relevant constructs to chronic d social activity, and mood in chronic low back pain. These results emphasize the importance of assessing injustice perception as a time-varying, rather than stable construct in future empirical and clinical studies.
The current study presents a validation of a daily version of the Injustice Experience Questionnaire in chronic low back pain. Results indicate that injustice appraisals vary significantly from day to day, and daily variability in injustice perception shows robust associations with pain intensity, pain-related interference in physical and social activity, and mood in chronic low back pain. These results emphasize the importance of assessing injustice perception as a time-varying, rather than stable construct in future empirical and clinical studies.
Helicobacter pylori is a gram-negative bacterium involved in many gastric pathologies such as ulcers and cancers. Although the treatment for this infection has existed for several years, the development of a vaccine is nevertheless necessary to reduce the severe forms of the disease. For more than three decades, many advances have been made particularly in the understanding of virulence factors as well as the pathogenesis of gastric diseases caused by H.pylori. Among these key virulence factors, specific antigens have been identified Urease, Vacuolating cytotoxin A (VacA), Cytotoxin-associated gene A (CagA), Blood group antigen-binding adhesin (BabA), H.pylori adhesin A (HpaA), and others.

This review will focus on H.pylori adhesins, in particular, on HpaA and on the current knowledge of H.pylori vaccines.

All of the information included in this review was retrieved from published studies on H.pylori adhesins in H.pylori infections.

These proteins, used in their native or recombinant forms, induce protection against H.
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